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Bubble CPAP splitting: innovative strategy in resource-limited settings.
Verma, Akanksha; Jaiswal, Rahul; Naranje, Kirti M; Gupta, Girish; Singh, Anita.
  • Verma A; Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
  • Jaiswal R; Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
  • Naranje KM; Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India drkirtinaranje@gmail.com.
  • Gupta G; Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
  • Singh A; Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Arch Dis Child ; 106(2): 137-140, 2021 02.
Article in English | MEDLINE | ID: covidwho-1039865
ABSTRACT

BACKGROUND:

Non-invasive respiratory support for neonates using bubble continuous positive airway pressure (bCPAP) delivery systems is now widespread owing to its safety, cost effectiveness and easy applicability. Many innovative solutions have been suggested to deal with the possible shortage in desperate situations like disasters, pandemics and resource-limited settings. Although splitting of invasive ventilation has been reported previously, no attempts to split non-invasive respiratory support have been reported.

OBJECTIVE:

The primary objective was to test the feasibility of splitting the bCPAP assembly using a T-piece splitter in a simulation model.

METHODS:

A pilot simulation-based study was done to split a single bCPAP assembly using a T-piece. Other materials consisted of a heated humidification system, an air oxygen blender, corrugated inspiratory and expiratory tubing, nasal interfaces and two intercostal chest tube drainage bags. Two pressure manometers were used simultaneously to measure delivered pressures at different levels of set bCPAPs at the expiratory limb of nasal interfaces.

RESULTS:

Pressures measured at the expiratory end of two nasal interfaces were 5.1 and 5.2 cm H2O, respectively, at a flow of 6 L/min and a water level of 5 cm H2O in both chest bags. When tested across different levels of set continuous positive airway pressure (3-8 cmH2O) and fractional inspired oxygen concentration (0.30-1.0), measured parameters corresponded to set parameters.

CONCLUSION:

bCPAP splitting using a T-piece splitter is a technically simple, feasible and reliable strategy tested in a simulation model. Further testing is needed in a simulated lung model.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Insufficiency / Continuous Positive Airway Pressure Limits: Humans / Infant, Newborn Country/Region as subject: Asia Language: English Journal: Arch Dis Child Year: 2021 Document Type: Article Affiliation country: Archdischild-2020-320030

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Insufficiency / Continuous Positive Airway Pressure Limits: Humans / Infant, Newborn Country/Region as subject: Asia Language: English Journal: Arch Dis Child Year: 2021 Document Type: Article Affiliation country: Archdischild-2020-320030